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SOCIAL STATUS AND PTSD IN U.S. VIETNAM VETERANS

美国越南退伍军人的社会地位和创伤后应激障碍

基本信息

批准号：
6392610
负责人：
BRUCE P DOHRENWEND
金额：
$ 36.38万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-09-28 至 2003-12-01
项目状态：
已结题

项目摘要

The broad objective is to explain differences in rates of Post-Traumatic Stress Disorder (PTSD) and comorbid disorders in U.S. Vietnam veterans from different social statuses indicated by gender, ethnic/racial background, and parental socioeconomic status (SES). The specific aims involve tests of alternative hypotheses about the primacy of exposure to environmental war- zone stressors, the role of antecedent personal predispositions, and the influence of endogenous cultural factors associated with the differing social statuses. The data for these tests come from the National Vietnam Veterans Readjustment Study (NVVRS). The NVVRS was conducted by the Research Triangle Institute (RTI) in response to a Congressional mandate to investigate PTSD and other psychological problems in the U.S. veterans. The study of nationwide samples of 3,016 Vietnam Theater veterans other Vietnam Era veterans, and non-veterans began in 1984, and the intensive data collection continued over the next several years. The veteran samples were drawn from military records and interviewed in detail about their premilitary lives, their military experiences, and their lives following the war as well as a wide variety of psychological symptoms and problems. In addition, a subsample of respondents consisting of 343 Theater veterans and 93 Era veterans were given intensive research diagnostic examinations by experienced clinicians. These subsample diagnoses contain the only data in the study on onset and course of PTSD, and reports of results of the study thus far have focused on current PTSD in the larger samples. The rate of current PTSD (present 15 to 20 years after the war) was 15.2 percent in male Theater veterans, six times as high as for the Era comparison sample. This rate of persistent or recurrent PTSD was especially high in Hispanics (27.9 percent) and African-Americans (20.6 percent) compared to nonHispanic whites (13.7 percent). These ethnic/racial differences are reduced but do not disappear when parental socioeconomic status (SES) is controlled. Among female Theater veterans, mainly nonHispanic white nurses, the 8.5 percent rate of current PTSD is substantially lower than for males. Very large majorities of both male and female Theater veterans with current PTSD were diagnosed with other concomitant psychiatric disorders. The reasons for these gender and racial/ethnic differences are unknown. The proposed study will focus almost exclusively on the diagnosed subsample in order to investigate alternative explanations of the group differences as the hypotheses apply to initial onset and to course of PTSD and comorbid disorders. Plans are set forth for utilizing existing measures and developing new ones necessary for the task from the NVVRS data, and for a variety of statistical analyses using descriptive statistics, graphical methods, and logistic and Gaussian multivariate regression. The long term goal is to increase knowledge of how humans adapt or fail to adapt to adversity and stress, and to contribute to the account of an historic event in the life of this nation.

广泛的目标是解释美国创伤后应激障碍（PTSD）和共病障碍的发生率的差异越南退伍军人从不同的社会地位表明的性别，种族/种族背景，和父母的社会经济地位（SES）。具体的目标涉及测试的替代假设的首要暴露于环境战区的压力，先行的个人倾向的作用，和内源性文化因素的影响与不同的社会地位。这些测试的数据来自国家越南退伍军人重新调整研究（NVVRS）。 NVVRS是由三角研究所（RTI）进行的，以响应国会的授权，调查美国退伍军人的创伤后应激障碍和其他心理问题。这项研究从1984年开始，在全国范围内对3,016名越战老兵、其他越战老兵和非老兵进行了抽样调查，并在接下来的几年里继续进行了密集的数据收集。退伍军人的样本来自军事记录，并详细采访了他们的战前生活，他们的军事经历，他们战后的生活以及各种各样的心理症状和问题。此外，由343名剧院退伍军人和93名时代退伍军人组成的受访者子样本由经验丰富的临床医生进行了深入的研究诊断检查。这些子样本诊断包含了研究中关于创伤后应激障碍发病和病程的唯一数据，迄今为止，研究结果的报告集中在较大样本中的当前创伤后应激障碍。目前PTSD的发生率（战后15至20年）在男性剧院退伍军人中为15.2%，是时代比较样本的六倍。与非西班牙裔白人（13.7%）相比，西班牙裔美国人（27.9%）和非洲裔美国人（20.6%）的持续或复发性PTSD率尤其高。这些民族/种族差异减少，但不消失时，父母的社会经济地位（SES）的控制。在女性剧院退伍军人中，主要是非西班牙裔白色护士，目前PTSD的8.5%的比率大大低于男性。绝大多数患有PTSD的男性和女性剧院退伍军人被诊断患有其他伴随的精神疾病。这些性别和种族/民族差异的原因尚不清楚。拟议的研究将集中在几乎完全诊断的子样本，以调查组差异的替代解释的假设适用于初始发病和过程中的创伤后应激障碍和共病障碍。计划提出利用现有的措施和开发新的必要的任务从NVVRS数据，并为各种统计分析，使用描述性统计，图形方法，逻辑和高斯多元回归。长期目标是增加人类如何适应或无法适应逆境和压力的知识，并为这个国家生活中的历史事件做出贡献。